IMPROVED INJECTION PRACTICES AFTER THE INTRODUCTION OF TREATMENT AND STERILITY GUIDELINES IN TANZANIA

OBJECTIVE To evaluate the effect of introduction of treatment and ster ilization guidelines on the number of avoidable injections and on the sterility of needles and syringes. METHODS In 1991, 66 randomly select ed health units in Mwanza Region, Tanzania, were visited and factors w ere determined that might contribute to HIV transmission by injections . In a workshop with all senior health workers from the region, findin gs were presented and treatment and sterilization guidelines developed . Thereafter, seminars were held at each health centre of the region. Four months after the intervention, data were collected at the same he alth facilities in order to assess changes in prescribing practices, s terilization procedures, and sterility of needles and syringes. RESULT S The knowledge on indications for injections improved markedly for pa ramedical staff. The proportion of outpatients receiving an injection dropped from 23% to 10% and the proportion of patients receiving an av oidable injection dropped from 16% to 6%. Procedures for sterilization , keeping sterilized equipment, and administration of injections impro ved. A smaller proportion of sterilized needles and syringes tended to be contaminated in dispensaries, but this reduction from 44% to 22% w as not significant. CONCLUSION Considerable improvement in knowledge, prescription practices and sterility procedures was observed at dispen sary level after carrying out a training programme.